Chapter 18 - Clinical Corner

It was already a very busy day in the infectious disease ward of the hospital. Patients were being admitted and discharged and others were being sent for tests. It is your responsibility to see that the rooms that are being vacated are cleaned and ready to receive new patients. You have a new nursing assistant to help you with this.
A. How will you explain the importance of the job at hand?
B. What procedures should you make your assistant aware of?

Question A: You must make sure that your assistant understands that the environment of the hospital is such that there is a serious problem with infections that arise in the hospital. Therefore it is essential to keep the hospital as clean as possible to prevent these nosocomial infections under control.
Question B: You should make sure that the new person is aware of all the standard operating procedures that are used in the hospital for disinfection and that this new person adheres to these protocols.

Hospital standard operating procedures require that you wash your hands regularly even though most of the time you are wearing rubber gloves when working with patients.
A. Why is washing your hands so important?
B. What effect will wearing rubber gloves have on the need for washing your hands?
C. Is hand washing in the hospital the same as at home?

As we have seen in previous chapters the simple act of washing your hands plays a major role in preventing infection. This question emphasizes the importance of washing your hands.
Question A: As we learned throughout our discussions, the skin is covered with organisms that have the potential to cause opportunistic infections. In addition, the hands are routinely coming in contact with potentially dangerous organisms. Consequently, keeping the hands as free as possible from these contaminating organisms in particular when working with patients who are already ill will be very important in preventing possible infections.
Question B: Although wearing rubber gloves is a requirement for many hospital procedures, it is still possible to cause the spread of infection while wearing them. In most cases the gloves will be sterile but even these can be contaminated over time. Also, wearing them does not disinfect your hands. Therefore the organisms found on your skin are still there and you should continue to wash your hands as often as possible.
Question C: There is a difference between the soaps you use at home and those you use in a clinical setting. Those that are used in the hospital will contain additives that increase the antibacterial activity of the soap.